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Old Fashioned Business Model Brings Health Care Into The Future

Hickory Medical clinic in Bellefontaine is one of Ohio's first direct primary care offices.
Renee Wilde
Hickory Medical clinic in Bellefontaine is one of Ohio's first direct primary care offices.

Dr. Ryan Kauffman is a family physician working in Logan County. He started out in a traditional medical practice, working between 100 and 120 hours a week, week after week. 

Dr. Kauffman had reached the point where he was burned out. He didn’t have time to spend with his young family. He didn’t have time to spend with his patients. So this doctor decided it was time to make a bold change that would benefit both his family, and his community.

Today on County Lines, Producer Renee Wilde discovers a rural doctor whose going back to a time when medical care was simpler.

On a busy side street in Bellefontaine, Ohio, located in an old building that used to be a movie theatre, lies what might be the future of rural medical care.

Hickory Medical is Dr. Ryan Kauffman’s answer to the growing frustration of both patients and Doctors to the problems within the health industry.

‘The first time I heard about I said well that’s interesting. That will never work. And certainly never work in a community like mine, “ says Dr. Kauffman,  “After nine years in a traditional practice, I just saw too many of my patients who were falling through the cracks, and people who are buying insurance on the private market are paying a thousand dollars a month or more for insurance, but that insurance doesn’t cover anything.”

Dr. Ryan Kauffman
Credit Renee Wilde / WYSO
Dr. Ryan Kauffman

So Dr. Kauffman took a different approach to family medicine and choose to offer something call Direct Primary Care, and he was one of the first Direct Primary Care offices in Ohio when he opened his doors two years ago.

His family practice uses a business model with old fashioned values to bring affordable health care into the future.

“We started with zero patients on day one, which is always a bit of an adventure,” Kauffman laughs,  “This is what I felt called to do. I felt that it was important to provide care for this community, because it is a community that is in terrible need of medical care.” 

In a 2012 Logan County Needs Assessment Survey by Urban University, the two services that residents felt were most needed, were better health care and care of the elderly. 40% indicated that they had no personal doctor, and over 30% indicated that they were taking care of someone with health problems.

Dr Kauffman explains that Direct Primary Care works, a lot like a gym membership. You pay a monthly fee. So in my practice for adult’s that’s thirty nine dollars a month. And for kids, when there’s an adult that’s a member it’s $19 a month. And when you come through the door, it’s $20.

Instead of the industry standard practice of scheduling patients every ten to fifteen minutes, there’s only two appointments every hour.

Dr. Kauffman say’s, “It really allows me time to focus on my patient. To understand what their values are and concerns are, because certainly what one of the most neglected parts in healthcare today is what the patient wants. I have some of my patients who are a little older who just tend to not go out in the winter, so we’ll tend to do a home visit there.”

On a visit to Ruth Godwin on her farm outside of Bellefontaine,  for Ruth, who is bedridden, having a Doctor that makes house calls has made it a lot easier for her to get treatment.

“It’s been a godsend to me, “ Ruth says from her bed, “And it was so hard to use this lift up here, and a sling, and try to get in my Jazzy. And I had to use my daughter’s handicap van to try and go someplace, and a lot of times we had to go clear to Lima, and that was hard. This way I can just stay in the bed, and call Dr. Kaufman, and he is right here.”

Ruth’s caregiver chimes in from the corner of the room, “He’s been wonderful for her, and for us also, because getting her up was a challenge. Cause usually there’s only one of us here at a time. And it was mainly me, trying to lift her, put her in her chair, get the lift off of her. I did it, but at the end it was getting worse and worse.”

Dr. Kauffman’s practice has become an important part of this rural community.  The Direct Primary Care model is drawing so many clients to his office that he’s currently working to bring in additional Doctors and expand his practice. 

The City of Bellefontaine chose to go with a Direct Primary Care plan, for city employees, which is expected to save both the city, and it’s employees, money. But for Police Officer Greg VanBuskirk, it’s also saves him time on office visits.

“A lot of times when I go to the Doctor before, if it was 6 months I had to fill paperwork out again every time I went in,” says VanBuskirk, “So then your sitting in the waiting room for 45 minutes to an hour, get stuck in a hallway for another 20 minutes or so before you ever seen the Doctor. So your spending half a day at the Doctor’s office. Where here, there’s no paperwork. I go in, get right in within 5 minutes, see the Doctor, get what I need and I’m out of there.”

While Direct Primary Care will never replace the mainstream medical practices funded by the insurance industry, it is slowly catching on. In the past two years over a dozen DPC offices are now scattered around Ohio. 

Dr. Kauffman says “It’s not unusual to have people that are driving an hour or more to come see us because what we offer is so much different than what’s available elsewhere. It’s really about relationship. It’s about the relationship between the doctor and the patient, and the doctor and the community.”

County Lines is WYSO's series on rural life, made possible by a grant from Ohio Humanities.

Renee Wilde is an award-winning independent public radio producer, podcast host, and hobby farmer living in the hinterlands of southwestern Ohio.
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